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at the Faculty of Health, Psychology & Social Care ISSue 02 | SPRING 2015
Research Matters
The University forWorld-Class Professionals
Inside this issue
Do tough people sing the blues?
Professor Peter Clough
Challenging stigma: social work and substance use
Professor Sarah Galvini
Getting the message: Raising awareness of AAC for children
with communication disabilitiesDr Janice Murray
Cold Water Immersion: Physiological or Psychological
benefit for athletes?
Nora Alshoweir
Living life to the full: safeguarding health and wellbeing
services across the lifespan
Professor Josie Tetley
What Next? Integrating
former drug users back into
the workforce
Dr Sheila Wilson
The Cost of Patient Care: Equity in resource allocation for
our health service
Dr Francis Fatoye
For many former substance misuse service users, overcoming alcohol and drug addiction can mark the start of a long road ahead. When treatment finishes, they may be left wondering ‘what next?’ as they try to get their life back on track and can often face a series of struggles. One such obstacle is how they integrate into the workforce after weeks, months or even years away.
So to help ease the transition, research from an MMU student
is being transferred directly into the NHS to help former service
users rebuild for the future.
Substance misuse specialist Dr Sheila Wilson works for the
Greater Manchester West Mental Health NHS Foundation Trust
and has been helping former drug users trying to make the
transition into employment, a theme that shaped her MSc and
PhD studies.
She developed a model that sought to tap into former drug users’
experiences of dealing with addiction by helping them to become
volunteers and later employees in the substance misuse field,
and at the same time helping them to build a new life and feed
back into the service that had once provided support.
“Most ex-user narratives already ‘end’ at the point where
treatment ends, leaving much to discover regarding what
happens next,” said Dr Wilson.
“Understanding the next transition stage is valuable in enhancing
recovery and treatment outcomes, and determining how best to
recruit, induct, train, supervise and support ex-user drug workers
in gaining paid employment within the substance misuse field.”
Participants told their story through a ‘process map’ (pictured)
to develop participant-structured narratives, with former service
users plotting key events chronologically while telling their story.
This invaluable insight allowed Dr Wilson to develop three
key stages of change from drug user to employee: transition,
disclosure and professional identity. The narratives explored many
barriers – such as lack of prior work or educational achievement,
negative staff attitudes and previous convictions – and
opportunities, which can include positive role models, support,
training, volunteering and employment.
She adds: “Many of the study’s recommendations are already
being adopted: disclosure training on volunteer programmes is
enabling ex-users to balance being a role model with selective
disclosure to safeguard their own and clients’ wellbeing while
optimising disclosure effectiveness.
“This is just one example of how the research is already
positively influencing ex-users’ experience in making the
transition to drug worker status in the substance misuse field.
Further developments include a range of positive behaviours and
strategies to help to them as they transition.”
As Associate Dean for Research, I am delighted to introduce our research in the faculty of Health, Psychology and Social Care.
The faculty is engaged in internationally recognised, innovative
research in Health and Social Change, embracing the disciplines
of Psychology, Physiotherapy, Nursing, Speech and Language
Pathology, Social Work, and Social Care.
Our research is coordinated by two Faculty Research Centres:
• the Health Research Centre: Disability, Ageing and Wellbeing,
which comprises four Research Groups:
– Ageing and Long Term Conditions
– Applied Psychology and Wellbeing
– Disability and Participation
– Health Services and Outcomes
• the Research Centre for Social Change: Community Wellbeing,
which comprises three Research Groups:
– Community and Critical Psychology
– Safeguarding and Critical Professional Practice
– Substance Use and Addictive Behaviours
In REF 2014, we made highly successful cross-faculty
submissions to UoA22 (Social Work and Social Policy) and UoA3
(Allied Health Professions, Dentistry, Nursing and Pharmacy);
61% and 73% (respectively) of our research was designated
‘world leading’ or ‘internationally excellent.’
For more about MMU’s REF performance, including our
internationally excellent impact case studies, see
http://www2.mmu.ac.uk/research/ref/
Strongly established and widely published in the field, our
two Research Centres and our faculty partner, the Centre for
Knowledge Exchange, bring together an impressive array of
research and knowledge exchange activity within MMU and
across our extensive regional, national and international networks.
We reflect the demands placed on policy makers, employers
and public services in the 21st century, through our integrated
approach both to research and to the issues affecting individuals,
communities and populations. We are involved in a wide range of
research projects in health, psychology and social care; you can
read about some exciting examples in this magazine.
We offer postgraduate supervision at Masters and Doctoral
level. We currently have over 80 doctoral students, including full
and part time students from the UK and a wide range of other
countries. See the opposite page for an exciting account of the
work of one of our recent Doctoral graduates, Dr Sheila Wilson.
For further information on postgraduate research degrees,
see the MMU website http://www2.mmu.ac.uk/research/
researchdegrees/.
We welcome opportunities for collaborative research and
applications from prospective postgraduate research students.
Contact details can be found on the back of this issue of
Research Matters.
I hope you will enjoy reading about the work some of our
researchers in the faculty of Health, Psychology & Social Care.
Professor Juliet Goldbart Associate Dean: Research
Welcome from Professor Juliet Goldbart
What Next? Integrating former drug users back into the workforceDr Sheila Wilson
Drug unit detox
Full-time support worker
18 months
Promoted senior support worker
3 years
Peer support group 3 months
Sessional worker 6 weeks
Completed Level 3 substance misuse practitioner course
Take over running the group
Volunteer on the detox unit 10 months
Community drug worker
For many former substance misuse service users, overcoming alcohol and drug addiction can mark the start of a long road ahead. When treatment finishes, they may be left wondering ‘what next?’ as they try to get their life back on track and can often face a series of struggles. One such obstacle is how they integrate into the workforce after weeks, months or even years away.
So to help ease the transition, research from an MMU student
is being transferred directly into the NHS to help former service
users rebuild for the future.
Substance misuse specialist Dr Sheila Wilson works for the
Greater Manchester West Mental Health NHS Foundation Trust
and has been helping former drug users trying to make the
transition into employment, a theme that shaped her MSc and
PhD studies.
She developed a model that sought to tap into former drug users’
experiences of dealing with addiction by helping them to become
volunteers and later employees in the substance misuse field,
and at the same time helping them to build a new life and feed
back into the service that had once provided support.
“Most ex-user narratives already ‘end’ at the point where
treatment ends, leaving much to discover regarding what
happens next,” said Dr Wilson.
“Understanding the next transition stage is valuable in enhancing
recovery and treatment outcomes, and determining how best to
recruit, induct, train, supervise and support ex-user drug workers
in gaining paid employment within the substance misuse field.”
Participants told their story through a ‘process map’ (pictured)
to develop participant-structured narratives, with former service
users plotting key events chronologically while telling their story.
This invaluable insight allowed Dr Wilson to develop three
key stages of change from drug user to employee: transition,
disclosure and professional identity. The narratives explored many
barriers – such as lack of prior work or educational achievement,
negative staff attitudes and previous convictions – and
opportunities, which can include positive role models, support,
training, volunteering and employment.
She adds: “Many of the study’s recommendations are already
being adopted: disclosure training on volunteer programmes is
enabling ex-users to balance being a role model with selective
disclosure to safeguard their own and clients’ wellbeing while
optimising disclosure effectiveness.
“This is just one example of how the research is already
positively influencing ex-users’ experience in making the
transition to drug worker status in the substance misuse field.
Further developments include a range of positive behaviours and
strategies to help to them as they transition.”
As Associate Dean for Research, I am delighted to introduce our research in the faculty of Health, Psychology and Social Care.
The faculty is engaged in internationally recognised, innovative
research in Health and Social Change, embracing the disciplines
of Psychology, Physiotherapy, Nursing, Speech and Language
Pathology, Social Work, and Social Care.
Our research is coordinated by two Faculty Research Centres:
• the Health Research Centre: Disability, Ageing and Wellbeing,
which comprises four Research Groups:
– Ageing and Long Term Conditions
– Applied Psychology and Wellbeing
– Disability and Participation
– Health Services and Outcomes
• the Research Centre for Social Change: Community Wellbeing,
which comprises three Research Groups:
– Community and Critical Psychology
– Safeguarding and Critical Professional Practice
– Substance Use and Addictive Behaviours
In REF 2014, we made highly successful cross-faculty
submissions to UoA22 (Social Work and Social Policy) and UoA3
(Allied Health Professions, Dentistry, Nursing and Pharmacy);
61% and 73% (respectively) of our research was designated
‘world leading’ or ‘internationally excellent.’
For more about MMU’s REF performance, including our
internationally excellent impact case studies, see
http://www2.mmu.ac.uk/research/ref/
Strongly established and widely published in the field, our
two Research Centres and our faculty partner, the Centre for
Knowledge Exchange, bring together an impressive array of
research and knowledge exchange activity within MMU and
across our extensive regional, national and international networks.
We reflect the demands placed on policy makers, employers
and public services in the 21st century, through our integrated
approach both to research and to the issues affecting individuals,
communities and populations. We are involved in a wide range of
research projects in health, psychology and social care; you can
read about some exciting examples in this magazine.
We offer postgraduate supervision at Masters and Doctoral
level. We currently have over 80 doctoral students, including full
and part time students from the UK and a wide range of other
countries. See the opposite page for an exciting account of the
work of one of our recent Doctoral graduates, Dr Sheila Wilson.
For further information on postgraduate research degrees,
see the MMU website http://www2.mmu.ac.uk/research/
researchdegrees/.
We welcome opportunities for collaborative research and
applications from prospective postgraduate research students.
Contact details can be found on the back of this issue of
Research Matters.
I hope you will enjoy reading about the work some of our
researchers in the faculty of Health, Psychology & Social Care.
Professor Juliet Goldbart Associate Dean: Research
Welcome from Professor Juliet Goldbart
What Next? Integrating former drug users back into the workforceDr Sheila Wilson
Drug unit detox
Full-time support worker
18 months
Promoted senior support worker
3 years
Peer support group 3 months
Sessional worker 6 weeks
Completed Level 3 substance misuse practitioner course
Take over running the group
Volunteer on the detox unit 10 months
Community drug worker
Currently in the UK, you have a statutory right to access a wheelchair if you cannot walk, or a hearing aid if you have a hearing impediment. However, if you have a communication disability, you do not have the same right to access similar support services or receive a communication aid.
During the last 10 years, momentum has gathered around the
need for a better understanding of Augmentative and Alternative
Communication (AAC) aided by the prominence of public users
such as Professor Stephen Hawking and stand-up comedian
Lee Ridley. But progress is still needed, according to Dr Janice
Murray.
Dr Murray is a Reader in Community Rehabilitation at
Manchester Metropolitan University, with a background in
speech and language therapy, specialising in AAC. Her research
focuses on creating better prospects for people who use aided
communication.
Her research impact includes the creation of the website www.
aacknowledge.org.uk, which provides summaries of research
evidence, practice strategies and case stories to inform a range
of stakeholders including professionals, parents, suppliers
and users of AAC technology. She is the Chair of Council for
the International Society for Augmentative and Alternative
Communication (ISAAC).
Dr Murray’s current work centres on children who, from birth,
have difficulties communicating. The project, titled ‘Becoming
an Aided Communicator’ led by Stephen von Tetzchner from
the University of Oslo, brings together experts from 16 different
countries including Germany, Australia and the USA.
The research was inspired by the tension created by current
communication aid technologies: a need to make devices simple
enough to use but at the same time not restricting language and
communication development. Such devices can include graphic
symbol systems that use symbols together with the word or
phrase it stands for and voice output communication aids, similar
to what is used by Professor Hawking.
The project seeks to map language development in children who
use aided communication. This will inform future assessment
protocols and system recommendations, making the experience
more relevant to the child with communication difficulties.
Dr Murray says: “A lot of evidence in the research literature
suggests that children who use aided communication to speak
and have no other learning difficulty do
not acquire the language and the literacy
skills of which they should be capable.
This suggests that there is something that
we have not got quite right in supporting
their language and communication
development. Long-term, this impacts
on their opportunities and prospects in
society.”
The current practice for assessing a
child’s need for aided communication
involves matching their skills against the
knowledge of typical language acquisition
development, which Dr Murray suggests
is unfair because ‘these children are not
learning to communicate in a typical way’.
Much of the crucial and fast-paced
language development for children
takes place in the first three years of
their lives, a stage when children with
communication difficulties and their
parents often struggle to come to terms
with the issues and struggle to find out
how they can access help.
Instead of focusing on how language
develops in all children, this research
charts how language is learned
by children who already use aided
communication and have been doing so
for two years. The project has tested
the patterns of learning in 100 children
between the ages of 5 and 15.
Dr Murray explains: “What we did as a
group was create unique and novel tasks
with the view of looking at the children’s
ability to understand language, and
also their expressive communication or
speaking skills. In this way we mapped
what was a typical speech and language
response in aided communicators.”
The evidence is currently being brought
together in a book to encourage
practitioners to use it. The hope is
that it becomes a reference text for
professionals assessing children who
may benefit from aided communication.
Overall, the goal with the research
is to increase the independence and
quality of life for those who use aided
communication, but also to help raise
awareness across society of these very
skilled and strategic children who get
their message across in a very different
but effective way.
One example of its success follows
Dr Murray’s research over 10 years when
she worked with a school to promote
the benefits of aided communication.
A young boy who had cerebral palsy, a
condition that left him without speech,
enrolled in the school.
After some tests, Dr Murray found
he was extremely bright for his age
and provided him with a speaking
communication aid which she installed
with a language representation system
developed with teenagers in mind.
Within one month, the child learned
to use the system by being able to
locate all the right vocabulary so that he
could create sentences and contribute
to a conversation in the same way as
any naturally speaking child. After two
months, the staff saw the communication
aid as his actual voice, no longer
automatically separating the child and the
machine. “He did in two months what
I had been trying to do over a 10-year
period of time. They finally got it, it was
fabulous,” she said.
Two years later the same child
successfully entered mainstream school.
Dr Murray believes the importance of this
is the overall acceptance and inclusion of
those who use aided communication in a
mainstream educational setting.
She added: “If we can get more kids
out into the mainstream setting, then I
think what we are trying to work towards
will be understood more and people will
get it. We all take being able to talk and
communicate for granted, here these kids
have to work so hard to just be normal.”
Dr Murray’s long-term aim is to develop
more thorough and coherent aided
communication systems for children,
providing them with greater prospects
in terms of employment and other
opportunities within society.
Getting the message: Raising awareness of AAC for children with communication disabilitiesDr Janice Murray
“The goal with the research is to increase the independence and quality of life for those who use aided communication, but also to help raise awareness across society.”
Currently in the UK, you have a statutory right to access a wheelchair if you cannot walk, or a hearing aid if you have a hearing impediment. However, if you have a communication disability, you do not have the same right to access similar support services or receive a communication aid.
During the last 10 years, momentum has gathered around the
need for a better understanding of Augmentative and Alternative
Communication (AAC) aided by the prominence of public users
such as Professor Stephen Hawking and stand-up comedian
Lee Ridley. But progress is still needed, according to Dr Janice
Murray.
Dr Murray is a Reader in Community Rehabilitation at
Manchester Metropolitan University, with a background in
speech and language therapy, specialising in AAC. Her research
focuses on creating better prospects for people who use aided
communication.
Her research impact includes the creation of the website www.
aacknowledge.org.uk, which provides summaries of research
evidence, practice strategies and case stories to inform a range
of stakeholders including professionals, parents, suppliers
and users of AAC technology. She is the Chair of Council for
the International Society for Augmentative and Alternative
Communication (ISAAC).
Dr Murray’s current work centres on children who, from birth,
have difficulties communicating. The project, titled ‘Becoming
an Aided Communicator’ led by Stephen von Tetzchner from
the University of Oslo, brings together experts from 16 different
countries including Germany, Australia and the USA.
The research was inspired by the tension created by current
communication aid technologies: a need to make devices simple
enough to use but at the same time not restricting language and
communication development. Such devices can include graphic
symbol systems that use symbols together with the word or
phrase it stands for and voice output communication aids, similar
to what is used by Professor Hawking.
The project seeks to map language development in children who
use aided communication. This will inform future assessment
protocols and system recommendations, making the experience
more relevant to the child with communication difficulties.
Dr Murray says: “A lot of evidence in the research literature
suggests that children who use aided communication to speak
and have no other learning difficulty do
not acquire the language and the literacy
skills of which they should be capable.
This suggests that there is something that
we have not got quite right in supporting
their language and communication
development. Long-term, this impacts
on their opportunities and prospects in
society.”
The current practice for assessing a
child’s need for aided communication
involves matching their skills against the
knowledge of typical language acquisition
development, which Dr Murray suggests
is unfair because ‘these children are not
learning to communicate in a typical way’.
Much of the crucial and fast-paced
language development for children
takes place in the first three years of
their lives, a stage when children with
communication difficulties and their
parents often struggle to come to terms
with the issues and struggle to find out
how they can access help.
Instead of focusing on how language
develops in all children, this research
charts how language is learned
by children who already use aided
communication and have been doing so
for two years. The project has tested
the patterns of learning in 100 children
between the ages of 5 and 15.
Dr Murray explains: “What we did as a
group was create unique and novel tasks
with the view of looking at the children’s
ability to understand language, and
also their expressive communication or
speaking skills. In this way we mapped
what was a typical speech and language
response in aided communicators.”
The evidence is currently being brought
together in a book to encourage
practitioners to use it. The hope is
that it becomes a reference text for
professionals assessing children who
may benefit from aided communication.
Overall, the goal with the research
is to increase the independence and
quality of life for those who use aided
communication, but also to help raise
awareness across society of these very
skilled and strategic children who get
their message across in a very different
but effective way.
One example of its success follows
Dr Murray’s research over 10 years when
she worked with a school to promote
the benefits of aided communication.
A young boy who had cerebral palsy, a
condition that left him without speech,
enrolled in the school.
After some tests, Dr Murray found
he was extremely bright for his age
and provided him with a speaking
communication aid which she installed
with a language representation system
developed with teenagers in mind.
Within one month, the child learned
to use the system by being able to
locate all the right vocabulary so that he
could create sentences and contribute
to a conversation in the same way as
any naturally speaking child. After two
months, the staff saw the communication
aid as his actual voice, no longer
automatically separating the child and the
machine. “He did in two months what
I had been trying to do over a 10-year
period of time. They finally got it, it was
fabulous,” she said.
Two years later the same child
successfully entered mainstream school.
Dr Murray believes the importance of this
is the overall acceptance and inclusion of
those who use aided communication in a
mainstream educational setting.
She added: “If we can get more kids
out into the mainstream setting, then I
think what we are trying to work towards
will be understood more and people will
get it. We all take being able to talk and
communicate for granted, here these kids
have to work so hard to just be normal.”
Dr Murray’s long-term aim is to develop
more thorough and coherent aided
communication systems for children,
providing them with greater prospects
in terms of employment and other
opportunities within society.
Getting the message: Raising awareness of AAC for children with communication disabilitiesDr Janice Murray
“The goal with the research is to increase the independence and quality of life for those who use aided communication, but also to help raise awareness across society.”
Students at Manchester Metropolitan University (MMU) may now have the edge over other graduates after the arrival of Professor Peter Clough. Having spent most of his academic career at The University of Hull in a variety of roles including Associate Dean, Professor Clough joined MMU in February 2014 as the Chair of Applied Psychology. His main focus is the area of mental toughness and the expertise he has gained over the years is being used to enhance student performance and employability.
Professor Clough has spent the last 15 years researching Mental
Toughness, initially as a sports and occupational psychologist,
developing his 4 ‘C’ model and the mental toughness
questionnaire MTQ48. However, he is now more interested in
the subtleties of the subject with a particular focus on sensitivity
and how sensitive people cope with the world.
“Mental toughness is often seen as a macho concept and we
talked a lot when we were developing it, about what to call it, and
mental toughness seems to be more honest. You can call it lots
of stuff but that’s what it is,” he explained.
With schools now using more exams rather than coursework,
the pressure placed on people in education can be debilitating,
especially if they are both introverted and sensitive. Also, with
most managerial positions within companies filled with people
who score highly on the MTQ48 questionnaire, it becomes
increasingly difficult for the more sensitive to succeed.
“Our mental toughness model developed out of sport, into
business and now most of its focus is in education. We have a
book out currently looking at mental toughness in education, the
reason that it’s interesting is because there is so much wasted
talent,” he said.
“Every time there is an assessment the more sensitive
people get ’taken out’, whilst the mentally tough people just
keep ‘ploughing on’. If you can’t deal with the pressures of
assessment in school, then you don’t do well.”
With students from traditionally working-class backgrounds
often under-performing in schools, the question of whether we
can develop toughness is becoming very pertinent. This may
allow disadvantaged children to achieve better results at school
and ultimately enjoy greater success in a working environment.
Professor Clough says that helping people
to achieve their potential is the socially
responsible thing to do; however, he
is philosophical about the benefits of
making everyone mentally tough and
believes we need to maintain and support
sensitive people in society.
“We’re interested in working in areas of
deprivation to try to help people get an
education - generally the only way out
of poverty is sport, music or education.
Throughout history, especially recently,
there have always been people that have
prospered in harsh conditions so that’s
where you start. Can we identify what
they do? Or: can we develop people to be
like that? And finally, the third and most
interesting question is: should we?”
He builds on that further by saying: “Can
mentally tough people sing the blues?
Sensitive people bring a lot to the party,
unfortunately they’re often not in a
position of power.”
Professor Clough is pleased to have
joined MMU, enjoying the eclectic mix
within the Psychology department. They
are applying his research to help MMU
students by introducing them to a range
of toughening techniques.
With regards to his own research he
says: “People who are drawn to mental
toughness training are often mentally
tough, it’s the sensitive people who
might need it that don’t come forward,
We don’t want to fundamentally change
them, we just want to give them a range
of options.”
He adds: “We try to give them tools and
techniques. Let’s say they can’t reach
the top shelf, we don’t make them taller
rather we give them something to step
on - that’s what we’re trying to do.” He
makes it clear that individual differences
obviously play a major role, and that the
Psychology department now encourages
students to take the mental toughness
questionnaire and the individual student’s
support is tailored to her or his needs
based on their results.
Regarding what he considers as success,
he believes that it should be what works
for you. He says it should not necessarily
be earning lots of money, it is doing
what you need to do. Professor Clough
explained: “That is mental toughness,
making your own decisions and not
from group pressure. It’s reaching
your full potential.” Professor Clough
hopes his future research will better
explain the cognitive underpinnings of
mental toughness and the explanation
of the mental toughness advantage. He
added: “There is definitely an advantage
but the question is why? What is it
that these people are doing that gives
the advantage? Is it cognitive? Is it
physiological? Or is it psychological?”
With his upcoming research, we may find
out the answer.
Do tough people sing the blues?Professor Peter Clough
Control
Confidence CommitmentMentalToughness
Challenge
Students at Manchester Metropolitan University (MMU) may now have the edge over other graduates after the arrival of Professor Peter Clough. Having spent most of his academic career at The University of Hull in a variety of roles including Associate Dean, Professor Clough joined MMU in February 2014 as the Chair of Applied Psychology. His main focus is the area of mental toughness and the expertise he has gained over the years is being used to enhance student performance and employability.
Professor Clough has spent the last 15 years researching Mental
Toughness, initially as a sports and occupational psychologist,
developing his 4 ‘C’ model and the mental toughness
questionnaire MTQ48. However, he is now more interested in
the subtleties of the subject with a particular focus on sensitivity
and how sensitive people cope with the world.
“Mental toughness is often seen as a macho concept and we
talked a lot when we were developing it, about what to call it, and
mental toughness seems to be more honest. You can call it lots
of stuff but that’s what it is,” he explained.
With schools now using more exams rather than coursework,
the pressure placed on people in education can be debilitating,
especially if they are both introverted and sensitive. Also, with
most managerial positions within companies filled with people
who score highly on the MTQ48 questionnaire, it becomes
increasingly difficult for the more sensitive to succeed.
“Our mental toughness model developed out of sport, into
business and now most of its focus is in education. We have a
book out currently looking at mental toughness in education, the
reason that it’s interesting is because there is so much wasted
talent,” he said.
“Every time there is an assessment the more sensitive
people get ’taken out’, whilst the mentally tough people just
keep ‘ploughing on’. If you can’t deal with the pressures of
assessment in school, then you don’t do well.”
With students from traditionally working-class backgrounds
often under-performing in schools, the question of whether we
can develop toughness is becoming very pertinent. This may
allow disadvantaged children to achieve better results at school
and ultimately enjoy greater success in a working environment.
Professor Clough says that helping people
to achieve their potential is the socially
responsible thing to do; however, he
is philosophical about the benefits of
making everyone mentally tough and
believes we need to maintain and support
sensitive people in society.
“We’re interested in working in areas of
deprivation to try to help people get an
education - generally the only way out
of poverty is sport, music or education.
Throughout history, especially recently,
there have always been people that have
prospered in harsh conditions so that’s
where you start. Can we identify what
they do? Or: can we develop people to be
like that? And finally, the third and most
interesting question is: should we?”
He builds on that further by saying: “Can
mentally tough people sing the blues?
Sensitive people bring a lot to the party,
unfortunately they’re often not in a
position of power.”
Professor Clough is pleased to have
joined MMU, enjoying the eclectic mix
within the Psychology department. They
are applying his research to help MMU
students by introducing them to a range
of toughening techniques.
With regards to his own research he
says: “People who are drawn to mental
toughness training are often mentally
tough, it’s the sensitive people who
might need it that don’t come forward,
We don’t want to fundamentally change
them, we just want to give them a range
of options.”
He adds: “We try to give them tools and
techniques. Let’s say they can’t reach
the top shelf, we don’t make them taller
rather we give them something to step
on - that’s what we’re trying to do.” He
makes it clear that individual differences
obviously play a major role, and that the
Psychology department now encourages
students to take the mental toughness
questionnaire and the individual student’s
support is tailored to her or his needs
based on their results.
Regarding what he considers as success,
he believes that it should be what works
for you. He says it should not necessarily
be earning lots of money, it is doing
what you need to do. Professor Clough
explained: “That is mental toughness,
making your own decisions and not
from group pressure. It’s reaching
your full potential.” Professor Clough
hopes his future research will better
explain the cognitive underpinnings of
mental toughness and the explanation
of the mental toughness advantage. He
added: “There is definitely an advantage
but the question is why? What is it
that these people are doing that gives
the advantage? Is it cognitive? Is it
physiological? Or is it psychological?”
With his upcoming research, we may find
out the answer.
Do tough people sing the blues?Professor Peter Clough
Control
Confidence CommitmentMentalToughness
Challenge
With cold water immersion (CWI) prevalent in sport, in particular with elite athletes, Nora Alshoweir has made it her mission to find out the benefits of the treatment, building on existing knowledge in the field to help athletes’ recovery, including those new to sport from her own country, Saudi Arabia.
Miss Alshoweir’s career has spanned 19 years, starting out as
a staff therapist before working her way up to the Head of the
Physiotherapy department at a military hospital. She initially
completed her Masters at MMU in 2008 before becoming part of
the medical team that travelled with the Saudi Royal Family. She
has since returned to the University and is currently finishing the
fourth and final year of her PhD, before returning home hopefully
to break down barriers and pioneer research into the effects of
CWI on Saudi women.
Miss Alshoweir’s research is focusing on how to alleviate the
soreness athletes feel due to intensive training or competitive
performance. Her intention is to help athletes understand how to
operate at a higher level for longer. CWI, usually following intense
exercise, is where the athlete is submerged into an ice bath for a
set period of time.
In her research, Miss Alshoweir carried out a three-phased study.
She said: “In phase one, active volunteers were immersed
into cold water once for 15 minutes and we measured their
physiological response for two days.”
She continued: “For phase two we used elite athletes and gave
them an exercise that caused a response called delayed onset
muscle soreness. We then separated them into two groups:
one had the CWI for 15 minutes and the other received passive
treatment, in which we had them sitting for the same duration.
Cold Water Immersion: Physiological or Psychological benefit for athletes?Nora Alshoweir
Afterwards we tested the athletes’
muscle strength and pain levels over
three days.
“Phase three was connected with phase
two; it was about the athletes’ perception
of their strength and pain. They were
interviewed on their expectations prior
to the study and their experience post-
CWI. We wanted to extract information
such as how did they feel physically
and emotionally. Did they feel it was
beneficial?”
Miss Alshoweir believes that, up to now,
the results showed that CWI provides
a benefit to the athletes; however, this
was not an obvious physiological benefit
but rather a psychological one. The
athletes believed that they were aware
of a reduction in pain and an increase in
muscle strength, she added, “From our
measurements we saw that there is no
physical benefit in regards to strength,
and yet overall the participants reported
their belief that they felt stronger
afterwards and reported subjectively that
they felt less pain.
However, Miss Alshoweir believes that
there needs to be more research into the
subject, suggesting that we need more
studies that test other sports to allow
the results to be generalised across all
sporting disciplines. She also believes
that most of the previous research into
the subject has focused on males and
that in the future more studies need to
look at the effect on females saying, “If
you want to establish a treatment base
then it needs to be suitable for all.”
Miss Alshoweir will submit her PhD in
July, and following that she intends to do
a similar study in Saudi Arabia to see if
there are any cross-cultural differences.
Initially she will be focusing on the
Saudi males so that she can compare
her current results, which are based on
British males, to see what the similarities
and differences are. Following on from
that she hopes to research the effects on
Saudi women, as it is only recently that
they have been allowed to participate in
competitive sport.
“Active volunteers were immersed into cold water once for 15 minutes and we measured their physiological response for two days.”
With cold water immersion (CWI) prevalent in sport, in particular with elite athletes, Nora Alshoweir has made it her mission to find out the benefits of the treatment, building on existing knowledge in the field to help athletes’ recovery, including those new to sport from her own country, Saudi Arabia.
Miss Alshoweir’s career has spanned 19 years, starting out as
a staff therapist before working her way up to the Head of the
Physiotherapy department at a military hospital. She initially
completed her Masters at MMU in 2008 before becoming part of
the medical team that travelled with the Saudi Royal Family. She
has since returned to the University and is currently finishing the
fourth and final year of her PhD, before returning home hopefully
to break down barriers and pioneer research into the effects of
CWI on Saudi women.
Miss Alshoweir’s research is focusing on how to alleviate the
soreness athletes feel due to intensive training or competitive
performance. Her intention is to help athletes understand how to
operate at a higher level for longer. CWI, usually following intense
exercise, is where the athlete is submerged into an ice bath for a
set period of time.
In her research, Miss Alshoweir carried out a three-phased study.
She said: “In phase one, active volunteers were immersed
into cold water once for 15 minutes and we measured their
physiological response for two days.”
She continued: “For phase two we used elite athletes and gave
them an exercise that caused a response called delayed onset
muscle soreness. We then separated them into two groups:
one had the CWI for 15 minutes and the other received passive
treatment, in which we had them sitting for the same duration.
Cold Water Immersion: Physiological or Psychological benefit for athletes?Nora Alshoweir
Afterwards we tested the athletes’
muscle strength and pain levels over
three days.
“Phase three was connected with phase
two; it was about the athletes’ perception
of their strength and pain. They were
interviewed on their expectations prior
to the study and their experience post-
CWI. We wanted to extract information
such as how did they feel physically
and emotionally. Did they feel it was
beneficial?”
Miss Alshoweir believes that, up to now,
the results showed that CWI provides
a benefit to the athletes; however, this
was not an obvious physiological benefit
but rather a psychological one. The
athletes believed that they were aware
of a reduction in pain and an increase in
muscle strength, she added, “From our
measurements we saw that there is no
physical benefit in regards to strength,
and yet overall the participants reported
their belief that they felt stronger
afterwards and reported subjectively that
they felt less pain.
However, Miss Alshoweir believes that
there needs to be more research into the
subject, suggesting that we need more
studies that test other sports to allow
the results to be generalised across all
sporting disciplines. She also believes
that most of the previous research into
the subject has focused on males and
that in the future more studies need to
look at the effect on females saying, “If
you want to establish a treatment base
then it needs to be suitable for all.”
Miss Alshoweir will submit her PhD in
July, and following that she intends to do
a similar study in Saudi Arabia to see if
there are any cross-cultural differences.
Initially she will be focusing on the
Saudi males so that she can compare
her current results, which are based on
British males, to see what the similarities
and differences are. Following on from
that she hopes to research the effects on
Saudi women, as it is only recently that
they have been allowed to participate in
competitive sport.
“Active volunteers were immersed into cold water once for 15 minutes and we measured their physiological response for two days.”
As we age, we change, but that doesn’t mean our health and wellbeing has to. Time may march on but fresh ideas and thinking are helping to debunk the myth that our quality of life drops as the years advance.
Industry-informing nursing research at Manchester Metropolitan
University is helping to address the issues we face as we age,
equipping society with the tools to tend to the physical and
emotional needs of older people.
There are currently 10 million people over 65 in the UK and that
number is projected to double by 2050. However, stakeholders
ranging from government to care providers are creating new
ways to help older people to keep living life to the full. The
Department of Nursing at MMU is playing its part by developing
new strategies for living with dementia, raising awareness of
glaucoma among nurses and highlighting the barriers to sexual
activity in older couples.
Josie Tetley, Professor of Nursing, draws on 28 years’ experience
as a qualified nurse, lecturing for 20 of those, to tackle the
questions raised by ageing and the questions faced by the next
generation of nurses.
“I wanted to try to make a difference in terms of how nurses
more broadly think about working with older people,” she says.
“That’s because working with older people can be seen as a
negative career option but it isn’t: it’s extremely fulfilling because
you’re having a direct impact on the wellbeing of a large group.
“An ageing society is not something to be feared and we can adapt
to safeguard our health and wellbeing as we age. Research is
leading the way in making progress, not only to meet the demands
of the next 50 years, but also to embrace and overcome them. ”
Professor Tetley is currently working with colleagues Professor
Janet Marsden and Donna Davenport on a project that is exploring
nurses’ knowledge and awareness of glaucoma management in
care homes. The project is funded by the International Glaucoma
Organisation and the Royal College of Nursing.
The research was initiated by the concern that nurses working
in care homes may not have access to the evidence-based
knowledge needed to manage this condition.
“Unfortunately, care homes tend to get cut off from some of the
mainstream education opportunities because the nurses are not
employed by the NHS,” said Professor Tetley.
“They often don’t get access to seminars or study days. So it was
vital that we understood how much was known by nurses and
what information they need so that older people’s glaucoma can
be effectively managed within care homes.”
This desire to improve the understanding of the ageing process
and issues that can arise from it grounds much of her other
research. Professor Tetley, in collaboration with Dr David Lee at
the University of Manchester, is currently working on a project for
the English Longitude of Ageing (E.LSA) focusing on the sexual
relations and activities of older people in later life, an under-
researched topic she says.
The project, which surveyed 7,000 people, is unique in that it
focuses on the sexual activity of couples rather than in older
people as individuals, a trend seen in most previous studies. The
survey also created an invaluable qualitative data set that she is
helping to analyse.
Findings from a previous study suggest that many older people
feel they are not being given the bigger picture by the health
professionals they visit. Although they may be told they have
diabetes or high blood pressure, it is not made clear how the
health conditions or the medications prescribed might affect
sexual health and wellbeing.
Initial findings from the work have been presented at the British
Society of Gerontology and at a joint seminar organised by MMU,
the Association of Education and Ageing and the Manchester
Institute and Centre for Ageing.
Looking to the future, she is turning her attention to dementia
with MMU’s Dr Jenny Fisher and Open University colleagues
after securing a successful funding bid from the Alzheimer’s
Society. The project starts later in 2015
and will evaluate an intensive home
support service for people living with
dementia.
Prior to joining MMU, Professor Tetley
had undertaken European work exploring
older people’s attitudes to engaging with
new and existing technologies. As part of
the ‘OPT-IN’ project, the team provided
spaces and places where older people
could engage informally with a range of
technological devices.
“We wanted to move away from the idea
that older people have to go to formal
classes to learn how to use technology,”
she explained.
The project also involved taking older
participants to Germany and The
Netherlands to meet their peers to see
how they use different technology.
Professor Tetley believes that by seeing
others playing and engaging with new
technologies and game consoles - such
as iPads and Nintendo Wiis - participants
become more confident to try things
themselves. For example, it inspired one
person to buy an iPad and others to open
the Nintendo Wii they had been given to
use at an Age UK centre.
Professor Tetley keenly emphasises that
service user and carer participation is at
the heart of most of her research, and
she works closely with members of the
Faculty service users and carer group. As
a result of her active engagement with
service users and carers in research, she
has been invited to be a member of the
People in Research North West working
group. This work is supported by NIHR’s
Research Design Service North West.
Professor Tetley said: “I am looking
forward to working with People in
Research North West and I hope that I
can help them build on the excellent work
that they have already undertaken in our
region and increase the outreach of the
group.
“It has been an exciting time moving
to Manchester Metropolitan University
and I look forward to leading more
ageing focused research that can make a
difference to the lives of older people and
those who support them.”
Living life to the full: safeguarding health and wellbeing services across the lifespanProfessor Josie Tetley
“An ageing society is not something to be feared and we can adapt to safeguard our health and wellbeing as we age. Research is leading the way in making progress, not only to meet the demands of the next 50 years, but also to embrace and overcome them.”
As we age, we change, but that doesn’t mean our health and wellbeing has to. Time may march on but fresh ideas and thinking are helping to debunk the myth that our quality of life drops as the years advance.
Industry-informing nursing research at Manchester Metropolitan
University is helping to address the issues we face as we age,
equipping society with the tools to tend to the physical and
emotional needs of older people.
There are currently 10 million people over 65 in the UK and that
number is projected to double by 2050. However, stakeholders
ranging from government to care providers are creating new
ways to help older people to keep living life to the full. The
Department of Nursing at MMU is playing its part by developing
new strategies for living with dementia, raising awareness of
glaucoma among nurses and highlighting the barriers to sexual
activity in older couples.
Josie Tetley, Professor of Nursing, draws on 28 years’ experience
as a qualified nurse, lecturing for 20 of those, to tackle the
questions raised by ageing and the questions faced by the next
generation of nurses.
“I wanted to try to make a difference in terms of how nurses
more broadly think about working with older people,” she says.
“That’s because working with older people can be seen as a
negative career option but it isn’t: it’s extremely fulfilling because
you’re having a direct impact on the wellbeing of a large group.
“An ageing society is not something to be feared and we can adapt
to safeguard our health and wellbeing as we age. Research is
leading the way in making progress, not only to meet the demands
of the next 50 years, but also to embrace and overcome them. ”
Professor Tetley is currently working with colleagues Professor
Janet Marsden and Donna Davenport on a project that is exploring
nurses’ knowledge and awareness of glaucoma management in
care homes. The project is funded by the International Glaucoma
Organisation and the Royal College of Nursing.
The research was initiated by the concern that nurses working
in care homes may not have access to the evidence-based
knowledge needed to manage this condition.
“Unfortunately, care homes tend to get cut off from some of the
mainstream education opportunities because the nurses are not
employed by the NHS,” said Professor Tetley.
“They often don’t get access to seminars or study days. So it was
vital that we understood how much was known by nurses and
what information they need so that older people’s glaucoma can
be effectively managed within care homes.”
This desire to improve the understanding of the ageing process
and issues that can arise from it grounds much of her other
research. Professor Tetley, in collaboration with Dr David Lee at
the University of Manchester, is currently working on a project for
the English Longitude of Ageing (E.LSA) focusing on the sexual
relations and activities of older people in later life, an under-
researched topic she says.
The project, which surveyed 7,000 people, is unique in that it
focuses on the sexual activity of couples rather than in older
people as individuals, a trend seen in most previous studies. The
survey also created an invaluable qualitative data set that she is
helping to analyse.
Findings from a previous study suggest that many older people
feel they are not being given the bigger picture by the health
professionals they visit. Although they may be told they have
diabetes or high blood pressure, it is not made clear how the
health conditions or the medications prescribed might affect
sexual health and wellbeing.
Initial findings from the work have been presented at the British
Society of Gerontology and at a joint seminar organised by MMU,
the Association of Education and Ageing and the Manchester
Institute and Centre for Ageing.
Looking to the future, she is turning her attention to dementia
with MMU’s Dr Jenny Fisher and Open University colleagues
after securing a successful funding bid from the Alzheimer’s
Society. The project starts later in 2015
and will evaluate an intensive home
support service for people living with
dementia.
Prior to joining MMU, Professor Tetley
had undertaken European work exploring
older people’s attitudes to engaging with
new and existing technologies. As part of
the ‘OPT-IN’ project, the team provided
spaces and places where older people
could engage informally with a range of
technological devices.
“We wanted to move away from the idea
that older people have to go to formal
classes to learn how to use technology,”
she explained.
The project also involved taking older
participants to Germany and The
Netherlands to meet their peers to see
how they use different technology.
Professor Tetley believes that by seeing
others playing and engaging with new
technologies and game consoles - such
as iPads and Nintendo Wiis - participants
become more confident to try things
themselves. For example, it inspired one
person to buy an iPad and others to open
the Nintendo Wii they had been given to
use at an Age UK centre.
Professor Tetley keenly emphasises that
service user and carer participation is at
the heart of most of her research, and
she works closely with members of the
Faculty service users and carer group. As
a result of her active engagement with
service users and carers in research, she
has been invited to be a member of the
People in Research North West working
group. This work is supported by NIHR’s
Research Design Service North West.
Professor Tetley said: “I am looking
forward to working with People in
Research North West and I hope that I
can help them build on the excellent work
that they have already undertaken in our
region and increase the outreach of the
group.
“It has been an exciting time moving
to Manchester Metropolitan University
and I look forward to leading more
ageing focused research that can make a
difference to the lives of older people and
those who support them.”
Living life to the full: safeguarding health and wellbeing services across the lifespanProfessor Josie Tetley
“An ageing society is not something to be feared and we can adapt to safeguard our health and wellbeing as we age. Research is leading the way in making progress, not only to meet the demands of the next 50 years, but also to embrace and overcome them.”
The healthcare system is faced with a puzzle: there is rising demand for services but budget pressures mean there are limited resources to meet this. Trying to strike this balance between cost and services – and its resulting effect on people – has spawned the discipline of health economics. Now, this young branch of economics is poised to become even more essential to healthcare.
Since 2012, the Government has sought to heighten the role
of those who actually provide care, through the Health and
Social Care Act. They moved to give care practitioners more
of an influence in deciding what treatment to provide for their
patients when Clinical Commissioning Groups replaced Primary
Care Trusts. This could create a dilemma for many healthcare
professionals: on the one hand wanting to offer their patients the
best treatment but also needing to assess the treatment’s cost-
effectiveness on the other.
One researcher trying to tackle this conundrum is Dr Francis
Fatoye, who joined MMU in 2006 and is now a Reader in
Physiotherapy, a profession he practised for many years
previously. His research interests are neuromusculoskeletal
conditions, health outcomes and health economics, including
economic evaluations. He has also become a pioneer for the
teaching and understanding of health economics.
But the focus on cost-effectiveness that surrounds health
economics is not something wholly money-related: the term ‘cost’
widens to include personal and emotional implications as well.
As part of his MSc in Health Economics and Health Policy,
Dr Fatoye looked at the impact of stroke rehabilitation on the
caregivers. The role of the caregiver and the impact on them is
not typically taken into account when assessing the effectiveness
of treatment, yet this can have big implications for resource use
by caregivers.
If a person’s caregiver, typically a close friend or family member,
has to take time off work then that can impact on not only
their economic situation, but also on their personal wellbeing.
Caregivers may no longer be able to carry out everyday tasks or
hobbies which they previously enjoyed
and this can also impact negatively on
their mood. Dr Fatoye believes this
should all be taken into consideration
when assessing the cost-effectiveness
of a treatment, admitting that relying
on caregivers might be ‘cheap for
government or healthcare providers but it
is not cheap for individual family members
or society’.
Dr Fatoye’s understanding of health
economics has also helped him in his
research on an international scale. “My
knowledge of health economics has
helped me understand how health care
systems work, not just in the UK, but all
over the world,” he adds.
He is currently working in
collaboration with Isfahan University
of Medical Sciences, in Iran, on
neuromusculoskeletal disorders. The
research focuses on the biomechanical
consequences associated with
musculoskeletal disorders, evaluating the
outcomes of interventions for patients
with these conditions.
Dr Fatoye believes the teaching of health
economics is crucial to the future of
providing the right care for patients but
it is also important for MMU. This belief
has seen health economics incorporated
into teaching on the MSc in Professional
Practice Development this year.
It has provided an avenue that has
enabled the University to stand apart and
nurture new partnerships. A collaboration
is being formed between multi-national
pharmaceutical company Astellas
Pharma Europe and the Faculty of Health,
Psychology and Social Care, with the
goal of creating a centre of excellence
in relation to health economics and
outcomes research. It is hoped that in
the long term there will be better, more
efficient care for patients.
Dr Fatoye believes that health economics
is not only focused on the expense
of a treatment, but also on assessing
the benefits associated with such
interventions. There is a need for equity
in resource allocation in healthcare and
fair access to health services, as it would
not be right to allocate vast amounts of
money to one sector and neglect another.
He says: “When people see health
economics they think it is only about cost
saving. It is not only about cost saving, it
is about providing the right information for
the right decision to be made. We need to
look at everything in totality.”
Although all healthcare practitioners want
the best care for their patients, weighing
up the cost effectiveness of treatment
becomes more central to care in the
current budgetary climate. This in itself
increases the importance of the current
and future teaching of health economics.
Dr Fatoye believes that if health
economics is embedded more thoroughly
into teaching and healthcare research, the
moral dilemmas that resonate become
less prominent. In turn, it does not then
have to be viewed as a negative part
of practice but as an essential part of
providing the very best treatment for
every patient.
The Cost of Patient Care: Equity in resource allocation for our health serviceDr Francis Fatoye
“Health economics is not only about cost saving, it is about providing the right information for the right decision to be made.”
The healthcare system is faced with a puzzle: there is rising demand for services but budget pressures mean there are limited resources to meet this. Trying to strike this balance between cost and services – and its resulting effect on people – has spawned the discipline of health economics. Now, this young branch of economics is poised to become even more essential to healthcare.
Since 2012, the Government has sought to heighten the role
of those who actually provide care, through the Health and
Social Care Act. They moved to give care practitioners more
of an influence in deciding what treatment to provide for their
patients when Clinical Commissioning Groups replaced Primary
Care Trusts. This could create a dilemma for many healthcare
professionals: on the one hand wanting to offer their patients the
best treatment but also needing to assess the treatment’s cost-
effectiveness on the other.
One researcher trying to tackle this conundrum is Dr Francis
Fatoye, who joined MMU in 2006 and is now a Reader in
Physiotherapy, a profession he practised for many years
previously. His research interests are neuromusculoskeletal
conditions, health outcomes and health economics, including
economic evaluations. He has also become a pioneer for the
teaching and understanding of health economics.
But the focus on cost-effectiveness that surrounds health
economics is not something wholly money-related: the term ‘cost’
widens to include personal and emotional implications as well.
As part of his MSc in Health Economics and Health Policy,
Dr Fatoye looked at the impact of stroke rehabilitation on the
caregivers. The role of the caregiver and the impact on them is
not typically taken into account when assessing the effectiveness
of treatment, yet this can have big implications for resource use
by caregivers.
If a person’s caregiver, typically a close friend or family member,
has to take time off work then that can impact on not only
their economic situation, but also on their personal wellbeing.
Caregivers may no longer be able to carry out everyday tasks or
hobbies which they previously enjoyed
and this can also impact negatively on
their mood. Dr Fatoye believes this
should all be taken into consideration
when assessing the cost-effectiveness
of a treatment, admitting that relying
on caregivers might be ‘cheap for
government or healthcare providers but it
is not cheap for individual family members
or society’.
Dr Fatoye’s understanding of health
economics has also helped him in his
research on an international scale. “My
knowledge of health economics has
helped me understand how health care
systems work, not just in the UK, but all
over the world,” he adds.
He is currently working in
collaboration with Isfahan University
of Medical Sciences, in Iran, on
neuromusculoskeletal disorders. The
research focuses on the biomechanical
consequences associated with
musculoskeletal disorders, evaluating the
outcomes of interventions for patients
with these conditions.
Dr Fatoye believes the teaching of health
economics is crucial to the future of
providing the right care for patients but
it is also important for MMU. This belief
has seen health economics incorporated
into teaching on the MSc in Professional
Practice Development this year.
It has provided an avenue that has
enabled the University to stand apart and
nurture new partnerships. A collaboration
is being formed between multi-national
pharmaceutical company Astellas
Pharma Europe and the Faculty of Health,
Psychology and Social Care, with the
goal of creating a centre of excellence
in relation to health economics and
outcomes research. It is hoped that in
the long term there will be better, more
efficient care for patients.
Dr Fatoye believes that health economics
is not only focused on the expense
of a treatment, but also on assessing
the benefits associated with such
interventions. There is a need for equity
in resource allocation in healthcare and
fair access to health services, as it would
not be right to allocate vast amounts of
money to one sector and neglect another.
He says: “When people see health
economics they think it is only about cost
saving. It is not only about cost saving, it
is about providing the right information for
the right decision to be made. We need to
look at everything in totality.”
Although all healthcare practitioners want
the best care for their patients, weighing
up the cost effectiveness of treatment
becomes more central to care in the
current budgetary climate. This in itself
increases the importance of the current
and future teaching of health economics.
Dr Fatoye believes that if health
economics is embedded more thoroughly
into teaching and healthcare research, the
moral dilemmas that resonate become
less prominent. In turn, it does not then
have to be viewed as a negative part
of practice but as an essential part of
providing the very best treatment for
every patient.
The Cost of Patient Care: Equity in resource allocation for our health serviceDr Francis Fatoye
“Health economics is not only about cost saving, it is about providing the right information for the right decision to be made.”
A leading researcher into problematic substance use and domestic violence has joined Manchester Metropolitan University after leaving the University of Bedfordshire (UoB). Professor Galvani was the Assistant Director of the Tilda Goldberg Centre for Social Work and Social Care at UoB for the past six years, and brings with her a wealth of expertise in research, as well as a passion for helping others.
Professor Galvani started along her path by volunteering for
‘Crisis at Christmas’ (now Crisis) before moving to the USA to
continue her work with homeless people, people experiencing
mental distress, and those with alcohol and other drug problems.
On her return to the UK, she trained to be a social worker and
maintains her registration to this day. Whilst in the USA she
became involved in work at street-based needle exchanges,
which further opened her eyes to the damage that problematic
substance use can cause.
She says: “My voluntary work with homeless people with
alcohol or other drug problems triggered both a practice and
academic interest. It led me into social work practice in terms of
wanting to provide support and advocate on their behalf, because
people with alcohol and other drug problems in particular are
often very marginalised.”
The shame and stigma felt by people with problematic
substance use can be a barrier to early intervention as the
problem is often hidden until it reaches crisis point. Professor
Galvani believes that there is no single cause of problematic
substance use, rather there is often a host of overlapping
issues that may be social, psychological and emotional.
However, she feels strongly that there is a particular lack
of acknowledgement about the social contributors and
consequences of problematic use.
“If you talk to people who provide drug and alcohol services, the
instances of abuse of different kinds - including childhood sexual
exploitation as well as domestic violence and abuse - is there,
alongside mental health problems, relationship difficulties, and
often physical health problems.”
She continued: “One thing that has happened policy-wise
is that people with alcohol and/or drug problems have been
seen as either sick and needing treatment or as criminals and
needing punishment.”
Her passion for highlighting the social causes and consequences
of substance use has informed her research career. In particular,
her research and curriculum development work has focused
on plugging gaps in social work training. Professor Galvani
believes that social workers are ideally placed for working with
the complexities of the issue; however, due to it being framed
as a criminal justice or treatment issue, there is a distinct lack
of education for social workers on the subject. In 2011, she
carried out the ‘National Survey of Social Workers: Experiences
of Working with Substance Use’ and found that approximately
a third of graduates had never experienced any training in this
field. A further third had received two days or less for what
is a significant part of many social workers’ jobs. Social care
professionals fared even worse.
Professor Galvani says: “What we need is a three-pronged attack
really, because we need the new workforce to have training in it,
we need to plug the gaps of the social workers in practice that
haven’t had much or any training, so that needs to be done by
employers or in-house training. But also we need to ramp up a
focus on substance use within the more formal post-qualifying
education where it can be tailored to particular areas of specialist
practice.”
Her research also encompasses
exploratory work with people who are not
the focus of mainstream research around
substance use. She recently completed
an exploratory study; Alcohol, other Drugs
and Sight Loss: A Scoping Study, funded
by the Thomas Pocklington Trust (TPT),
who support people with sight loss, and
Alcohol Research UK. The study was
motivated by practitioner reports of the
increasing number of people presenting to
services who have both alcohol and sight
loss problems, and a concern about how
best to support people with both issues.
“Once we started talking it raised bigger
questions, like what is the relationship
between substance use and sight loss?
Is there a medical relationship, a causal
relationship, or are they two separate
things that just happen to co-exist?
Maybe alcohol and other drugs are coping
mechanisms? The importance of doing
that work was that it emerged from the
ground up, from frontline practice. It’s
about services saying what can we do
better, what can we do differently?”
Related to the substance use and sight
loss research, Professor Galvani is
currently developing practice guidelines
for professionals funded by TPT to
help sight loss and substance use
professionals support people who
are struggling with both issues. This
application of research to practice, and
education, is at the core of Professor
Galvani’s work.
She has also recently conducted an
ethnographic study exploring substance
use within a Punjabi Sikh community to
inform service development in the region.
Professor Galvani now has a number of
other projects on the horizon, including
work on child-to-parent violence, alcohol
and older people, and end-of-life care
for people with alcohol and other drug
problems.
However, she is also continuing to focus
on social work and social care, clarifying
social workers’ roles and capabilities for
working with substance use, whatever
their area of specialist practice. In March
she launched the first ever national
guidance for social workers Alcohol
and other Drug Use: The Roles and
Capabilities of Social Workers.
Funded by Public Health England, the
document was developed alongside
a working group with representation
from The College of Social Work, the
British Association of Social Work, the
Associations of Directors of Adults’
and Children’s Services and Public
Health.“Importantly,” she states, “we have
a large group of social work practitioners
involved in its development too.”
The applied nature of her research is
clearly a priority for Professor Galvani.
She said: “As academics we have certain
targets to meet in terms of research
income and outputs in particular, such
as writing for peer-reviewed journals.
What I’m very conscious of as someone
who is interested in applied research
is that we need to be disseminating to
the practitioners as well as the other
audiences. I think that’s the challenge
we have at the moment with the current
ways of assessing what we do.”
Challenging stigma: social work and substance useProfessor Sarah Galvani
“We need to ramp up a focus on substance use within the more formal post-qualifying education where it can be tailored to particular areas of specialist practice.”
A leading researcher into problematic substance use and domestic violence has joined Manchester Metropolitan University after leaving the University of Bedfordshire (UoB). Professor Galvani was the Assistant Director of the Tilda Goldberg Centre for Social Work and Social Care at UoB for the past six years, and brings with her a wealth of expertise in research, as well as a passion for helping others.
Professor Galvani started along her path by volunteering for
‘Crisis at Christmas’ (now Crisis) before moving to the USA to
continue her work with homeless people, people experiencing
mental distress, and those with alcohol and other drug problems.
On her return to the UK, she trained to be a social worker and
maintains her registration to this day. Whilst in the USA she
became involved in work at street-based needle exchanges,
which further opened her eyes to the damage that problematic
substance use can cause.
She says: “My voluntary work with homeless people with
alcohol or other drug problems triggered both a practice and
academic interest. It led me into social work practice in terms of
wanting to provide support and advocate on their behalf, because
people with alcohol and other drug problems in particular are
often very marginalised.”
The shame and stigma felt by people with problematic
substance use can be a barrier to early intervention as the
problem is often hidden until it reaches crisis point. Professor
Galvani believes that there is no single cause of problematic
substance use, rather there is often a host of overlapping
issues that may be social, psychological and emotional.
However, she feels strongly that there is a particular lack
of acknowledgement about the social contributors and
consequences of problematic use.
“If you talk to people who provide drug and alcohol services, the
instances of abuse of different kinds - including childhood sexual
exploitation as well as domestic violence and abuse - is there,
alongside mental health problems, relationship difficulties, and
often physical health problems.”
She continued: “One thing that has happened policy-wise
is that people with alcohol and/or drug problems have been
seen as either sick and needing treatment or as criminals and
needing punishment.”
Her passion for highlighting the social causes and consequences
of substance use has informed her research career. In particular,
her research and curriculum development work has focused
on plugging gaps in social work training. Professor Galvani
believes that social workers are ideally placed for working with
the complexities of the issue; however, due to it being framed
as a criminal justice or treatment issue, there is a distinct lack
of education for social workers on the subject. In 2011, she
carried out the ‘National Survey of Social Workers: Experiences
of Working with Substance Use’ and found that approximately
a third of graduates had never experienced any training in this
field. A further third had received two days or less for what
is a significant part of many social workers’ jobs. Social care
professionals fared even worse.
Professor Galvani says: “What we need is a three-pronged attack
really, because we need the new workforce to have training in it,
we need to plug the gaps of the social workers in practice that
haven’t had much or any training, so that needs to be done by
employers or in-house training. But also we need to ramp up a
focus on substance use within the more formal post-qualifying
education where it can be tailored to particular areas of specialist
practice.”
Her research also encompasses
exploratory work with people who are not
the focus of mainstream research around
substance use. She recently completed
an exploratory study; Alcohol, other Drugs
and Sight Loss: A Scoping Study, funded
by the Thomas Pocklington Trust (TPT),
who support people with sight loss, and
Alcohol Research UK. The study was
motivated by practitioner reports of the
increasing number of people presenting to
services who have both alcohol and sight
loss problems, and a concern about how
best to support people with both issues.
“Once we started talking it raised bigger
questions, like what is the relationship
between substance use and sight loss?
Is there a medical relationship, a causal
relationship, or are they two separate
things that just happen to co-exist?
Maybe alcohol and other drugs are coping
mechanisms? The importance of doing
that work was that it emerged from the
ground up, from frontline practice. It’s
about services saying what can we do
better, what can we do differently?”
Related to the substance use and sight
loss research, Professor Galvani is
currently developing practice guidelines
for professionals funded by TPT to
help sight loss and substance use
professionals support people who
are struggling with both issues. This
application of research to practice, and
education, is at the core of Professor
Galvani’s work.
She has also recently conducted an
ethnographic study exploring substance
use within a Punjabi Sikh community to
inform service development in the region.
Professor Galvani now has a number of
other projects on the horizon, including
work on child-to-parent violence, alcohol
and older people, and end-of-life care
for people with alcohol and other drug
problems.
However, she is also continuing to focus
on social work and social care, clarifying
social workers’ roles and capabilities for
working with substance use, whatever
their area of specialist practice. In March
she launched the first ever national
guidance for social workers Alcohol
and other Drug Use: The Roles and
Capabilities of Social Workers.
Funded by Public Health England, the
document was developed alongside
a working group with representation
from The College of Social Work, the
British Association of Social Work, the
Associations of Directors of Adults’
and Children’s Services and Public
Health.“Importantly,” she states, “we have
a large group of social work practitioners
involved in its development too.”
The applied nature of her research is
clearly a priority for Professor Galvani.
She said: “As academics we have certain
targets to meet in terms of research
income and outputs in particular, such
as writing for peer-reviewed journals.
What I’m very conscious of as someone
who is interested in applied research
is that we need to be disseminating to
the practitioners as well as the other
audiences. I think that’s the challenge
we have at the moment with the current
ways of assessing what we do.”
Challenging stigma: social work and substance useProfessor Sarah Galvani
“We need to ramp up a focus on substance use within the more formal post-qualifying education where it can be tailored to particular areas of specialist practice.”
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